Concurrent Validity and Reliability of an Inertial Measurement Unit for the Assessment of Craniocervical Range of Motion in Subjects with Cerebral Palsy

Abstract

Objective: This study aimed to determine the validity and reliability of Inertial Measurement Units (IMUs) for the assessment of craniocervical range of motion (ROM) in patients with cerebral palsy (CP). Methods: twenty-three subjects with CP and 23 controls, aged between 4 and 14 years, were evaluated on two occasions, separated by 3 to 5 days. An IMU and a Cervical Range of Motion device (CROM) were used to assess craniocervical ROM in the three spatial planes. Validity was assessed by comparing IMU and CROM data using the Pearson correlation coefficient, the paired t-test and Bland–Altman plots. Intra-day and inter-day relative reliability were determined using the Intraclass Correlation Coefficient (ICC). The Standard Error of Measurement (SEM) and the Minimum Detectable Change at a 90% confidence level (MDC90) were obtained for absolute reliability. Results: High correlations were detected between methods in both groups on the sagittal and frontal planes (r > 0.9), although this was reduced in the case of the transverse plane. Bland–Altman plots indicated bias below 5º, although for the range of cervical rotation in the CP group, this was 8.2º. The distance between the limits of agreement was over 23.5º in both groups, except for the range of flexion-extension in the control group. ICCs were higher than 0.8 for both comparisons and groups, except for inter-day comparisons of rotational range in the CP group. Absolute reliability showed high variability, with most SEM below 8.5º, although with worse inter-day results, mainly in CP subjects, with the MDC90 of rotational range achieving more than 20º. Conclusions: IMU application is highly correlated with CROM for the assessment of craniocervical movement in CP and healthy subjects; however, both methods are not interchangeable. The IMU error of measurement can be considered clinically acceptable; however, caution should be taken when this is used as a reference measure for interventions.

Measuring Spinal Mobility Using an Inertial Measurement Unit System: A Validation Study in Axial Spondyloarthritis

“…In recent years, new tools able to measure movement have emerged, such as portable inertial measurement units (IMUs). This technology is beginning to be used in classic applications of motion capture, such as in gait analysis [16][17][18] or in the assessment of trunk [19][20][21][22] and cervical mobility [23]. The versatility, low cost, and size mean that assessments can extend beyond the clinic, including self-assessments of mobility, which can be shared remotely with the clinician [24].…”

Design, Validity, and Reliability of a New Test, Based on an Inertial Measurement Unit System, for Measuring Cervical Posture and Motor Control in Children with Cerebral Palsy

“…The current results of the new test showed a stable pattern of association with functional parameters in CP individuals, with this pattern being more evident for the performance of activities relevant to daily function in both activity and participation domains, assessed with PEDI, rather than the capacity of execution of motor skills, assessed by the GMFM-88 [ 64 ]. Thus, the amount of the flexion-extension movement was inversely proportional to the execution of motor function, which can be explained by the need of a constant motor control of the head against gravity to maintain the posture [ 32 ]. Although a specific explanation of the relationship between age and gross motor function is beyond the objective of this paper, the different demands of the GMFM-88 according to patient age could justify this association.…”

“…Thus, we determined that at least 21 individuals were necessary in the CP group. In addition, based on previous studies [ 32 , 40 , 41 ], and considering an intraclass correlation coefficient (ICC) of 0.8, an accuracy of 0.23, and a level of significance of 5%, the estimated sample should consist of at least 22 individuals (Tamaño de la muestra 1.1 ® software (Pontificia Universidad Javeriana, Bogotá, Colombia). Due to the follow-up period, 10% data loss was expected, and 24 individuals were assessed in each group.…”

Validity and reliability of inertial sensors for elbow and wrist range of motion assessment

“…They also play a promising role in quantifying patients' ROM and daily living activities such as reaching and grasping (Ertzgaard et al, 2016). There are also promising results testing their validity and reliability to assess the ROM of the cervical joint in subjects with CP (Carmona-Pérez et al, 2020).…”